Healthcare Provider Details

I. General information

NPI: 1174175608
Provider Name (Legal Business Name): CHRISTINE ALLISON CAMPBELL AGACNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHRISTINE ALLISON MCJUNKIN

II. Dates (important events)

Enumeration Date: 07/15/2019
Last Update Date: 02/28/2024
Certification Date: 02/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 W FARIS RD
GREENVILLE SC
29605-4255
US

IV. Provider business mailing address

300 E MCBEE AVE FL 4
GREENVILLE SC
29601-2842
US

V. Phone/Fax

Practice location:
  • Phone: 864-455-7070
  • Fax: 864-454-4669
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number23018
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: